WETHERBY SENIOR SCHOOL
100 Marylebone Lane, London W1U 2QU
Post Applied For:

1. Your Personal Details:

Mr/Mrs/Ms/Miss/Other: / Forenames:
Surname:
Home Address:
Post Code:
Home Phone Number: / Mobile Phone Number:
Home Email Address:
N.I. Number: / DfES Teacher Number
(If applicable):
If selected for appointment, you will be asked to produce evidence of your entitlement to work in the UK, in accordance with the Asylum and Immigration Act 1996.
Are you a UK or European Union citizen? / YES / NO
Do you need a work permit to take up employment in the UK? / YES / NO
If Yes, do you already have a work permit for your current employment? / YES / NO
Are you in the UK on a working holiday or other temporary visa? / YES / NO
This post is an exempted occupation under the Rehabilitation of Offenders Act 1974 (Exemptions) Order 1975. Any offer of employment will be conditional on an enhanced disclosure application to the Disclosure & Barring Service. Your signature on this form will be regarded as agreement to such an application. Having a criminal record will not necessarily prevent you from being employed by the Group – please see separate DBS Disclosure Policy Statement
Have you ever been convicted of a criminal offence or are you currently subject to proceedings? If yes please provide full details in a sealed envelope marked “Confidential”. / YES / NO
Are you prevented from accepting regulated employment by virtue of to being listed in the Children’s barred List maintained by the Independent Safeguarding Authority? / YES / NO
2. Qualifications and Training: / Please give details of your education and qualifications
Most recent first – continue on a separate sheet if necessary
Dates / School, College, University etc. / Subjects Studied / Qualifications / Certificates / Grades
From / To

Membership of Professional Bodies

3. Employment History:

Present or Most Recent Employment

Employer:
Employer’s Address:
Post Code:
Post Held:
Date Commenced: / Notice Required or Leaving Date:
Reason for Leaving:
Full / Part Time: / Grade: / Annual Salary:
Outline of Main Duties with any positions of responsibility (with dates):

Previous Appointments

(Most recent first – Please explain any gaps in employment - continue of separate sheet if necessary)

From / To / Employer (including name and address) / Post Title / Main Duties / Reason for Leaving
4. Referees: / Please provide details of three referees, of whom one must be your current/most recent employer – at least one reference will be taken prior to interview.
1. Present or Most Recent Employer:May we approach prior to interview?YES / NO
Organisation:
Name: / Position:
Address:
Post Code:
Phone Number: / Email Address:
2. Other Professional Referee:May we approach prior to interview?YES / NO
Name: / Position:
Address:
Post Code:
Phone Number: / Email Address:
3. Personal Referee:Referee must have known applicant for at least four years.
Name:
Occupation:
Address:
Post Code:
Phone Number: / Email Address:

5. Supporting Statement:

Please attach to your application a supporting statement (not exceeding two sides of A4 paper) indicating why you are suitable for this position, highlighting how your skills, abilities and previous experience are relevant, and why you are interested in this position.

6. Declaration:

I hereby confirm:

  • that all the information given in this application is correct,
  • that all the questions relating to me have been accurately and fully answered,
  • that I am in possession of the qualifications I claim to hold, and
  • that I am eligible to work in the UK.

I understand that any offer of employment is strictly subject to satisfactory references, medical clearance and enhanced criminal records disclosure, and that any false statement may disqualify me from appointment or render me liable to summary dismissal.

I understand that the information given in this application may be held on computer systems and processed in accordance with the Data Protection Act 1998, and I hereby consent to the storage and use of that information for personnel administration purposes.

Signature: ______Date: ______

N.B Applicants should also complete a separate Equal Opportunities Monitoring Form

The name of school is part of the Alpha Plus Group of schools and colleges, and all staff of the school are employees of the Group. The Alpha Plus Group Ltd is registered in England (Registered no: 438111) and its registered office is at 50 Queen Anne Street, London W1G 8HJ.

© Alpha Plus Group Ltd 2007. This application form complies with the requirements of Safeguarding Children and Safer Recruitment, guidance published by the Department for Education and Skills in December 2006.

Application for EmploymentPage 1 of 6Version 5January 2014